免气囊分离器无钉合完全腹膜外腹腔镜腹股沟疝修补术246例报告  

Laparoscopic Total Extraperitoneal Herniorrhaphy with Non-stapling of the Mesh without using Dissection Balloon:Report of 246 Cases

作　　者：吴国贤[1] 罗衡桂[1] 杨应林[1] 胡月明[1] 戴江峰[1] 张爱民[1] 

机构地区：[1]浙江省杭州市萧山第一人民医院普外科,杭州311201

出　　处：《中国微创外科杂志》2010年第8期729-731,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨免气囊分离器无钉合完全腹膜外腹腔镜疝修补术（laparoscopic total extraperitoneal herniorrhaphy,TEP）的可行性。方法 2006年1月~2009年6月,在全麻下行免气囊分离器无钉合完全腹膜外腹腔镜疝修补术246例（262侧）,其中斜疝191侧,直疝71侧。结果手术全部成功,单侧手术时间（68.3±11.8）min（40~100min）,术中出血量5~25ml。术后住院时间（4.0±1.5）d（2~7d）。术中腹膜破裂5例,腹壁气肿7例,阴囊血肿或血清肿4例,无其他手术并发症。230例随访时间6~24个月,平均16个月,其中172例〉12个月,未见复发及腹股沟区慢性疼痛等并发症。结论免气囊无钉合TEP手术安全可行。Objective To explore the feasibility of laparoscopic total extraperitoneal herniorrhaphy（TEP）with non-stapling of mesh without using dissection balloon.Methods Under general anesthesia,246 patients with 262 inguinal hernias（16 patients had bilateral inguinal hernia）were treated by laparoscopic TEP with non-stapling of mesh in our hospital from January 2006 to June 2009,no dissection balloon was employed during the operation.Among the cases,191 cases showed indirect inguinal hernia,and 71 cases had direct inguinal hernia.Results All the operations were successfully completed.The mean operation time for one-side hernia was（68.3±11.8）min（ranged from 40 to 100 min）.During the operation,5-25 ml of blood loss was collected.After the operation,the patients was discharged from hospital in（4.0±1.5）d（2-7 d）.During the operation,5 cases had peritoneal laceration,7 developed abdominal emphysema,and 4 showed hematoma or seroma.Follow-up was achieved in 230 of the cases for 6-24 months with a mean of 16 months（12 months in 172 cases）,during which no chronic pain in operation area occurred.Conclusions TEP is safe for inguinal hernia with fast postoperative recovery,less pain,and low rate of recurrence.In addition,it can be used for bilateral inguinal hernia.

关 键 词：腹腔镜 腹股沟疝 免气囊分离器 疝修补术 

分 类 号：R656.21[医药卫生—外科学]